Imaging at the 2016 Olympics: Can an MRI ankle study help prevent future injuries?

High-level athletes are prone to injury. A recent study of MRI-detected ankle injuries at the 2016 Olympics in Rio de Janeiro found more than 20 percent of such injuries were preexisting. The full results, published in Academic Radiology, may improve the image-guided care of athletes moving forward.

“Acute and chronic injuries of the ankle are common sports injuries in high level competitive athletes and in recreational sports, and they can disrupt performance, affect return to play or long-term disability if not diagnosed or treated in a timely fashion,” wrote Rafael Heiss, MD, of the University of Erlangen-Nuremberg in Germany, and colleagues. “The knowledge acquired from imaging for the most common injuries affecting athletes from various Olympic disciplines is important and may provide guidance for management and prevention in the future.”

Of the 11,274 athletes who participated in the 2016 Olympics, 89 were referred for an ankle MRI. Nearly half of the MRIs were done on track and field athletes.

After analyzing these scans, the team found 89 athletes (99 percent) had at least one abnormal finding for an average of 6.2 abnormal findings per exam. Heiss et al. considered 21 percent to be preexisting and 79 percent were caused by an acute or subacute injury.

Tendon injuries proved to be the most common acute injuries, the authors noted. A majority of those were low-grade and occurred in ball sport athletes, such as soccer players or runners. The highest proportion of preexisting injuries per athlete were in non-ball sport athletes and occurred in the anterior talofibular ligament.

A systemic review of the 2016 Games found the ankle to be the third most commonly injured region, behind the knee and thigh, according to the authors. Additionally, the group found eight percent of all athletes suffered at least one injury during the Rio Games. Forty percent of these injuries resulted in loss of competition for at least one day and 20 percent resulted in loss of competition for more than seven days.

“Our results may help in planning medical injury surveillance systems for future large-scale sports events tailored for each specific sport and may potentially aid in developing preventive efforts before and during competition,” the authors wrote.